Monthly Archives: July 2016

I am near the art museum. I am going to see a patient. I had intended to see this patient and then another one before taking my nephew out for breakfast. I had spoken to him last night. He was depressed. He wouldn’t tell me what was wrong. All he did was cry. I was worried. I asked him to go to breakfast with me. We could talk face to face. I told him not to worry whatever was happening we would take care of it. He wept hard then and said, “I don’t think there’s anything you can do but I’ll be there.” And me, always the optimist and the one who thinks she knows everything, replied, “ We’ll handle it, don’t worry, Tommy.” Because I’m your aunt and I’m a nurse. I heal people. I’ll make you better.”

I saw my first patient at 7 am. She’s a diabetic. She’s blind. I check her sugar. It’s 355. I give her an insulin shot. I check her feet and do her blood pressure. I make her breakfast. Not because I have to but because I want to. I’m that kind of person.
I see my second patient. He has wounds on his legs. They drain terribly. They hurt him so much he cant get a decent night’s sleep. I comfort him the best that I can for he’s an old man, alone, having outlived his wife and children. I wash his legs. I pat them dry. I apply medicine to his painful wounds, cover them with dressings, and then I wrap his legs. He says he feels much better and off I go.
I’m in my car. I travel on the back streets to avoid the rush hour traffic that is now bumper to bumper.
I turn onto Spring Garden Avenue and that’s when I get a call from my husband. I pick up the phone. “Hi, what’s up,” I try to keep the annoyance out of my voice.
“Are you driving?’
“Yes, Of course, I’m driving.” Now I’m really annoyed.
My husband’s voice is deep and serious devoid of its usual jovial tone. “Pull over.”
I don’t ask any questions. The annoyance has left me. I’m scared.
“What’s wrong?”
“Turn off the car.”
“What’s wrong?” I begin to cry because I know something is wrong. Something is terribly wrong.
“Tommy. Tommy is dead.”
I wail, “ No. No. That’s impossible? He was meeting me for breakfast.”
“He went to hang out with friends. When they woke up they found him dead.”
“I’m heading over,” I weep.
My heart fills up my chest. It is beating so hard I can feel my carotids pulsating with blood.
I cry uncontrollably. I claw at my face. Then I calm down into a numbness. I drive on the avenue and wipe away tears. Then Tommy as a little boy flashes before me and I breakdown all again.
I was going to treat you to your favorite breakfast, Tommy- Thick slices of toast dipped in egg and cinnamon and vanilla, cooked to perfection then dusted with powered sugar, dripping in syrup. And sausage- almost crispy- nobody loves sausage like you.

My mouth is twisted in agony. Tears dribble down my cheeks like rivulets of rain against a windowpane. People stare at me with worried looks. I want to tell them, “My Nephew is dead. He’s only 19. How can a 19 year old be dead?”
This is a mistake, I tell myself even though I know there is no mistake.
I pull up to my sister’s house. There is a huge crowd. Immediately they surround me. Kids are crying. Adults are crying. My sister’s sister in law tells me Tommy was found on the third floor, the back bedroom. “He’s still in the house. Do you want to see him?”
I nod. She takes my hand and leads me to the house my Aunt and Uncle once lived in.
Another crowd is standing outside the house. This was a close neighborhood when I was growing up and it still is. The crowd steps aside to let me through. All of them knew Tommy since he was born. I know these people, too. I grew up with them but now I can’t remember a single name.
I go into a house I had not stepped foot in since my aunt and uncle passed away- that was many years ago. It was a well-kept house back then but now it’s filthy. It reeks of urine, and garbage. My throat burns and I sneeze over and over again. What were you doing in this house, Tommy?
I walk up to the third floor and step into the bedroom. Dirty mattresses are scattered on the floor. Trash is everywhere. The cops are there. A priest is there. My sister and my brother in law are there, too, standing in a corner, staring with large wide eyes; too shocked to do anything.
But I can do something. I’m a nurse. I’m a healer.
I look down at my nephew. His body is gray and stiff, dry vomit and blood have caked around his mouth and nose. Broken blood vessels that look like a mass of spider webs have darken his sweet handsome face.

I’m here, Tommy. I took care of you when you were a little boy and I’ll take care of you again.
I kneel. I put one hand on my nephew’s frozen chest and place the other hand over it. I press down again and again. I lean forward. I tilt Tommy’s head back. I lift his jaw. The cops are stunned at first then one- a young man of no more than 25 years takes me by my shoulders and pulls me up. “He’s gone, miss.”
“Gone? How can he be gone when I was talking to him last night? We were supposed to have breakfast this morning- French toast and sausage.” The cop gives me a sad, sad look as he pulls me back. I jerk away. I’m not disrespectful but I’m firm. “No, you’re wrong. I need to do CPR. That will revive him.” I am very controlled or at least I think I’m controlled.
“Miss, please. I have to ask you to stand back.”
I ignore the cop. I go back to Tommy. I have to save him. I know I can. How many people have I saved in my career? “Come on, sweetheart. Wake up. I’ll get you cleaned up and out of this hellhole. I’ll take you wherever you want to go.”

The cop gently takes my hand. “You’re his aunt.”
“Yes,” Hysteria rises in my voice, taking control of my body.
“Miss, there’s nothing else you can do. Please don’t make this difficult.”
I look into his eyes. They are pleading. I wail then quickly stop. My mind suddenly clears. Its like the sun finally pierced through heavy clouds. Ambulance drivers have arrived. I look at the priest then back at the cop. “Can I please kiss my nephew goodbye?” The cop nods. I kneel once more and press my forehead against his. I’m shocked at how cold and hard it is. How can that be when once it was so warm and soft? I can barely breathe. My body has separated itself. My mind no longer controls it. Tears drip onto Tommy’s face and gently cascade down his closed eyes and onto his cheeks.
“Come on, Tommy, get up! You’re just messing with me. I know you, Tommy. You were always a joker. How many practical jokes did you play on Brittany and me? I lost count. Please, Tommy, open your eyes, and laugh. I won’t be mad. I promise. “
I hear a stretcher being unfolded. A silver bag is being opened. They’re going to place Tommy in that bag. This is not a practical joke. This is for real.
I stand up. There’s only one thing left to do. “Father, can you pray with me?” My voice is so quiet and still. The priest takes my hand and I bow my head. To my surprise, the cops and the ambulance drivers, my sister and my brother in law, and his sister gather around and pray, too.

I leave the room so the EMT’s and the police can do their job. I slowly descend the steps. My hand slides down the wall to steady myself. How many times did I run up and down these stairs when I was a kid? I don’t remember. It was a happy house then- full of people and parties but now it’s an ugly house.
As I walk through the pallor, images of Tommy dance before my blurry eyes- Tommy at the beach, jumping the waves holding Brittany and his sister’s hands; looking up at me as I read him bedtime stories; tormenting Brittany only to be tormented by Bill; using Brittany’s dead, desiccated rabbit for a football then pleading forgiveness when Brittany crying her eyes out told me; his blue eyes sparkling, his chubby cheeks and those dimples so perfect. How could I not forgive him? I always forgave him.
Then he turned 16 and he slipped away from me- back to his mother and his old neighborhood. Why did I let him go?

I’m outside now. I step into the crowd. People take hold of my hands and squeeze lightly. I feel their grief and that comforts me.

The door opens. The priest steps out. The police step out. My sister and her husband step out. Then the paramedics carrying a silver bag on a stretcher step out. Wails erupt. I try so hard to be stoic but I can’t. I’m shaking uncontrollably.
A young man, his eyes swollen from tears, approaches me. He says he was Tommy’s best friend. He tells me he and a bunch of other kids were with Tommy last night. He was the one who woke up and found him dead. “We were just having fun. You know getting high, just a few pills and booze, that’s all.”
That’s all? Just having fun?
I blink at him in amazement then I lunge at him. The boy makes no effort to defend himself. Instead he covers his face sobbing and collapses to the ground. I stop. The urge to beat him to a pulp is gone. He’s already been beaten.

Your Aunt and Uncle’s old house is a crack house.
Liar.
Your nephew was there almost every night.
Liar.
He was popping oxycodone like they were candy. He was snorting crack and meth.
Liar.
The money you gave him was used to get high.
Liar.
Everybody in the neighborhood knew except you.
Liar.

My nephew would never take drugs!! Never. Never. Do you hear me? Never. Lies. All lies.
People stare at me. There is pity in their eyes. They knew about Tommy and they knew I didn’t know.
I look at each one of them then it hits me. Tommy was a drug addict. It wasn’t bullshit. It wasn’t a lie.
I refused to see what everyone else saw- the slurred speech, the weight loss, the inability to hold a job, money stolen, the glassy look in his eyes, the haggard look. Why didn’t I see?
Oh my God. Why didn’t I want to see?

That night, after I spoke to my nephew, he went to my Aunt and Uncle’s old house. He drank a large amount of liquor. He took Oxycodone, Xanax and Motrin. Sometime, during the night, he began to retch- too much Motrin can tear your stomach up- but he was in such a somnolent state- due to the Xanax and Oxycodone- he was unable to wake up. He aspirated his vomit. The vomit went into his lungs. He suffocated.

Just 19 years old. 19 years isn’t enough! No, no!

We all watch as Tommy is placed in the ambulance. We watch as it slowly pulls away and then disappears.

I have to leave. I can’t stand to be where I am. People are talking at me but I don’t hear a word. I’ll see them soon enough I say. My eyes can’t focus. I can’t make out faces. I can’t make out anything.
I make it to my car and get inside. I don’t have the energy to start it. Instead, I cover my eyes. I want to blot out my last image of Tommy. I don’t want to remember the vomit and blood, his mottled skin or how hard his chest was when I pressed into it. God, please erase it. Please, don’t torment me. As if on cue, my son’s christening flickers before me. Tommy was so proud of being chosen godfather. That was less than a month ago.
Oh, you silly boy. You thought you were a Peter Pan. You were immune from death. But you were wrong. Now, it’s too late. No second chances. No college. No walk down the aisle. No children of your own.
I grasp the steering wheel hard to control my shaking. How am I going to go on without Tommy? How is Brittany going to go on? She doesn’t even know.
Then I feel something. It’s sweet and light like a warm breeze brushing against my skin. It’s a whisper. I know that whisper. It’s Tommy. I hear his voice calling for me- from years ago. He’s a little boy again. He’s looking for me. Then I hear his voice again- this time in song. Oh what a voice he had.
At the age of 13, he sang solo- “Ave Maria” at St. Anne’s church. The evening sunlight streaming into the church illuminates his handsome face. He’s so close I can reach out and touch him. His voice resonates loud and clear.
Now another memory more recent- he’s a young man dancing at Zak’s christening. He has a microphone in hand and he’s belting out one Elvis Presley song after another. People are oohing and aahing over him like he’s a superstar himself. My mind is now full of song-happy songs. Tommy has reached out to me. I know it. I can feel it.
I laugh at the memories. There are so many. Tommy’s life passes before my eyes like a summer night ablaze in stars.

In my grief, Tommy has come to my rescue.

Dear Tommy, I thought you would bury me. If only I had known I would have saved you.
If only I had been there… if only…

I can’t believe how quickly time passes. A week has gone by since I went to New Hampshire and climbed to the summit of Mt. Washington.
There are bigger mountains to tackle but Mt Washington, the tallest mountain on the East coast, isn’t easy.

It’s famous for its brutal sudden weather changes. As a matter of fact, the highest wind gusts ever recorded were taken at its weather observatory.

I did my homework before I went on this hike. I made sure I had gloves, good hiking boots, long pants, and sweater, ski pants and jacket along with the usual food and water.
To me, that’s common sense but a lot of the hikers I ran into– mostly young adults- were dressed in shorts, sneakers, and short sleeve shirts.
Half way up the mountain, the temperature dropped. Those same hikers were now turning back because their hands were burning and they were cold.
At 6,000 feet, the temperature dropped into the thirties and it started to sleet but my hiking buddy and I pressed on. It wasn’t so physically strenuous as it was dangerous. We had to climb up and over slippery rocks. Some of the climbs had drops of ten feet or more. If you fell you would either die or suffer serious injury. A few times, our feet slipped but we were able to hang onto the crevices we dug our fingers into. I’m not exaggerating when I say we were scared. Thankfully, we ran into three Canadian men- they were lost, too. They never left us even though I’m sure we slowed them down. What a Godsend they were.
As soon as I finished my hike, I headed straight for the coffee shop. Inside, there was a poster that listed the names and ages of those who died on the mountain. Most were in their twenties. A few died from falling –at the same areas I had just hiked through- yiii!

But, the majority of deaths were due to hypothermia.
The last death occurred not in the dead of winter but in JULY!
What happened to these unfortunate hikers?
They underestimated the mountain. They weren’t careful. They didn’t have proper shoes or clothing. They got lost. They got caught in a storm and become disoriented. They went hiking alone.
I had a scary experience. My hiking buddy and I got caught in sleet and strong winds. We got disoriented and began to panic. If it weren’t for the Canadian men, we would have been in trouble.

Fortunately, this hike was a triumph for me. I made the summit. I also learned a few lessons.
#1- Never go hiking alone in rugged terrain. At least three people are optimal. If someone gets hurt, one can stay and another can get help.
Injury was a great concern for me. Suppose, one of us fell, broke a leg, or got stuck in between the rocks, it would haven taken hours before help arrived.
# 2- Communicate- Always tell friends or family members, where you are going and what time you expect to return. We had no reception on the mountain. Our cell phones were worthless. Next hike, I’ll bring my walkie-talkies – in case of an emergency. (Three of our group turned back- they could have had a walkie talkie and we would have been able to communicate).
Carry a whistle. If all else fails use your whistle to get attention. Someone is bound to hear you- hopefully sooner than later.
Mark your trail – make a rock cairn, use ribbon or chalk to mark a tree so you don’t get lost. If you do, your family or friends will know where to start looking. (We took the Lions’ head trail, which turned out to be the most strenuous trail- we didn’t know that- LOL. It was poorly marked and we got lost.)

#3- Be prepared for the worst. Never assume. You never know what’s going to happen. Bring proper clothing, water, socks, snacks, food (Dried foods can be bought at Eastern Mountain sports, and REI) compass, first aid kit, all weather blanket, waterproof gloves, waterproof pants and jacket.

#4- Know your body. It will tell you when it’s had enough.
Don’t ignore the symptoms of hypothermia- sometimes they creep up on you.

Signs of hypothermia are –

You’re cold. You shiver then you shiver uncontrollably- this is your body’s automatic defense. It’s telling you to seek shelter or dress properly. Keep in mind as your core temperature falls, shivering stops.

The nose, ears, fingers and toes are the most vulnerable and will be the first to indicate trouble. They burn/sting and then go numb. Eventually, the tissues freeze then die. This is known as Frost bite. When frost bite happens- the nose, ears, toes and/or fingers blackened then literally fall off/snap off- this doesn’t happened right away – sometimes it takes weeks or months and it’s extremely painful.

As the hypothermia progresses- confusion, unsteady gait, slurred speech or mumbling set in. If hypothermia is severe enough, the brain cant function properly. Vision blurs. Decision-making is impaired. Hikers wander off aimlessly. They lose sense of self and do crazy things like taking off their clothes.

In an effort to increase body heat, the body increases its metabolism by increasing respirations. The heart beats harder and faster. Unfortunately, this dramatic attempt to maintain body heat leads to extreme fatigue and eventual collapse. Panic sets in. Confusion increases. If help doesn’t arrive, the vital organs freeze, the blood freezes, and the body dies.

Deaths from hypothermia are avoidable. It doesn’t just happen while hiking in mountains, it can happen anywhere even in your own home.

Being aware of your body and being prepared for severe weather even in July is key to keeping yourself safe.